Provider Demographics
NPI:1487735544
Name:HOHERZ, DAVID G (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:G
Last Name:HOHERZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 SW MULVANE ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1678
Mailing Address - Country:US
Mailing Address - Phone:785-235-1170
Mailing Address - Fax:785-235-1153
Practice Address - Street 1:634 SW MULVANE ST
Practice Address - Street 2:SUITE 106
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1678
Practice Address - Country:US
Practice Address - Phone:785-235-1170
Practice Address - Fax:785-235-1153
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0416130208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSB68225Medicare UPIN
KS000316Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER NUMBE
KS016544Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER